Tearing of soft material of the joints is very common, the most common being tearing of the anterior cruciate ligament (ACL) of the knee: grafts the ends of which are inserted in tibial and femoral bone tunnels are used for replacement thereof.
Compared to the use of bone-tendon-bone grafts, soft material grafts, autografts, allografts or synthetic grafts are used increasingly more often, which grafts at the femoral level are secured by means of transverse or suspension devices and at the tibial level they are secured by means of interference screws or washers with transtibial screws, which have the advantage of leaving the healing perimeter free and of providing a greater retaining force compared with interference screws.
In single tibial-femoral tunnel surgical techniques, in which the fascicles of soft material are suspended at the femoral level, the washer with a single transtibial screw is a very reliable solution at the tibial level; however, in new techniques that achieve restoring the helical anatomy of the original cruciate ligament by means of three femoral tunnels and three tibial tunnels, it would be necessary to use three long transtibial screws, which is not acceptable.